Interplay of attention deficit hyperactivity disorder and risky behavior : exploring the mediating and moderating influence of student perception of the teacher on basic psychological needs (Hebrew)

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity and impulsivity. ADHD symptoms pose a challenge in meeting the demands that schools place on students, such as sitting still and listening for long periods. Therefore, there is a need to treat ADHD. Recognizing and treating ADHD in children helps improve academic achievement, whereas untreated ADHD can lead to many negative outcomes, including risk behavior. Risk behavior is defined as intentional behavior involving a certain probability of undesirable consequences with high risk. Risk behavior has been linked to the two symptom clusters of ADHD: inattention and hyperactivity/impulsivity. As part of the factors that may influence a student's risk behavior, the role of the teacher can be particularly significant. The humanistic approach in education sees the teacher as someone willing to go beyond school-related subjects, and is perceived by the student as a combination of a friend, parent and therapist. Therefore, there is a need to examine the teacher's ability to influence risk behavior of their students in general and those with ADHD in particular.
The main goal of the study was to examine the mediating and moderating role of the student's perception of the teacher as supporting or thwarting their basic psychological needs in the relationship between ADHD and risk behavior. The current study is grounded in the main conceptualization of self-determination theory with regard to the school system. "Self-determination theory" focuses on emotional, motivational and developmental aspects, and provides a theoretical basis for conceptualizing the various processes taking place in different frameworks, including the school setting. According to the self-determination theory, people have three basic and universal psychological needs that must be met in order to achieve self-determination. These are the need for relatedness and belonging, the need for competence, and the need for autonomy. The theory also distinguishes factors that may undermine the child's intrinsic motivation, such as psychological control and autonomy suppression, which are also addressed in the study. Previous research shows that teacher-student relationships are of great importance in a child's development, adjustment and mental well-being. Studies indicate that the formation of a meaningful relationship between a teacher and a student can positively predict academic outcomes, motivation to learn, social status, a sense of security, adjustment, and school
ii
attendance, and negatively predict dropout and anti-social and risk behavior. The study examined the variable of ADHD, which is known to be associated with risk behavior, and at the same time with difficulties in adapting functioning according to school requirements and developing good relationships between students and their teachers. The importance of the teacher-student relationship is most significant for all students, and especially for students with special needs. The present study attempted to examine this in the context of ADHD, based on theories regarding other groups at risk. In addition, this study highlighted the contribution of early positive teacher-student relationships for students with ADHD to relationship outcomes beyond the school setting. Specifically, the present study examined two main hypotheses: The first research hypothesis is a mediation hypothesis, whereby ADHD will predict teacher-student relationships, which in turn will predict risk behaviors. The second research hypothesis is a moderation hypothesis, whereby teacher-student relationships will moderate the influence of ADHD on risk behavior.
To test the hypotheses, a quantitative research method was chosen that included two time points (longitudinal study), through which it is possible to estimate the change in the dependent research variables as a function of the predictor variables. The analysis of the findings was performed using the Cross Lagged Panel Model (CLPM) data analysis array. The study followed the development of students with varying levels of ADHD symptoms. The study included middle-school students who completed questionnaires at two different time points: at the end of 8th grade, and one year later, at the end of 9th grade. The study was conducted between 2022–2023. The research variables were measured using self-report questionnaires.
In the first measurement, 578 8th grade students from 56 different classes from 14 public middle-schools participated. The attrition rate from the first to the second measurement time was 31%, so the sample at the second time point included 397 students.
Regarding the mediation hypothesis, which deals with the extent to which the student's perception of the teacher as supporting or thwarting their basic psychological needs (and peer support and parental monitoring as control variables) mediates the relationship between ADHD and risk behavior, the hypothesis was not supported. Evidence was found that ADHD increases risk behavior over time. Additionally, evidence was found that ADHD decreases the student's perception of the teacher as supportive, increases the student's perception of the teacher as
iii
thwarting, and reduces parental monitoring. However, supporting or thwarting needs, as well as peer relationships and parental monitoring, did not in turn predict changes in risk behaviors.
Regarding the moderation hypothesis, which states that positive teacher-student relationships moderate the influence of ADHD on risk behavior, the findings showed that the positive contribution of ADHD to increased risk behavior decreased as teacher support increased and as the student's perception of the teacher as thwarting decreased. In situations where teachers were perceived as more supportive and less thwarting, the positive contribution of ADHD to risk behavior decreased. The findings suggest that even when perceptions of teacher support were high and frustration was low, the relationship between ADHD and risk behavior remained significant. In actuality, teacher-student relationships reduced but did not eliminate the influence of ADHD on risk behavior. The findings indicate that the interaction between ADHD and the student's perception of the teacher as supportive or thwarting must be considered in order to understand the student's level of risk behavior.
The results of this study assist in our understanding of self-determination theory in relation to students with ADHD outside the school setting. This research provides support to the claim that children and adolescents with ADHD may be at risk for lack of support to basic psychological needs according to self-determination theory. It is important to develop teacher training programs based on self-determination theory, including both supporting the student's needs and avoiding thwart of students' basic psychological needs, particularly for students with ADHD. Improving these relationships may create an environment that helps reduce risk behaviors outside the school setting. Additionally, awareness should be raised among teachers, student teachers, and teacher educators about the impact of the quality of relationships with students with attention disorders. Another significant finding in this study concerns the confirmed link between ADHD and risk behavior. This finding emphasizes the need for preventive treatment in and outside the education system.
Keywords: Attention Deficit Hyperactivity Disorder, Risk Behavior, Self-Determination Theory, Student's Perception of Teacher, Fulfillment of Psychological Needs, Need Support, Thwart of Psychological Needs, Risk Behavior Outside School Setting